Provider Demographics
NPI:1295063568
Name:ELBERT, ERIC E (BA, MA, NBC-HIS)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:E
Last Name:ELBERT
Suffix:
Gender:M
Credentials:BA, MA, NBC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7342 BELL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-3545
Mailing Address - Country:US
Mailing Address - Phone:804-559-4625
Mailing Address - Fax:804-559-4627
Practice Address - Street 1:7342 BELL CREEK RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3545
Practice Address - Country:US
Practice Address - Phone:804-559-4625
Practice Address - Fax:804-559-4627
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101 001458237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist